Missed diagnosis of traumatic brain injury in patients with traumatic spinal cord injury.

摘要

In more than half of the traumatic spinal cord injury patients referred for in-patient rehabilitation, acute care diagnoses of traumatic brain injury were missed. A risk factor for missed diagnosis was an injury caused by a mechanism other than an MVC (e.g., falls, assaults), perhaps due to reduced expectations of traumatic brain injury in non-MVC patients. In our research study, we employed multiple assessments to aid diagnosis, which is particularly important for detecting the milder traumatic brain injuries often associated with spinal cord injury; unfortunately, limited resources may preclude a comprehensive diagnostic approach in clinical settings. Our findings point to the need to examine current acute care diagnostic protocols, and to increase vigilance in patients with traumatic injuries sustained outside of an MVC setting.